Please use this identifier to cite or link to this item: https://hdl.handle.net/2445/219622
Title: Routine invasive strategy and frailty burden in non-ST-segment elevation acute myocardial infarction
Author: Nuñez, Julio
Ariza Solé, Albert
Andrés Bermeo, Juan
Formiga Pérez, Francesc
Bueno, Héctor
Miñana, Gemma
Alegre Canals, Oriol
Martí, David
Martínez-Sellés, Manuel
Domínguez-Pérez, Laura
Díez Villanueva, Pablo
Barrabés, José A.
Marín, Francisco
Villa, Adolfo
Sanmartín-Fernández, Marcelo
Llibre, Cinta
Sionis, Alessandro
Carol, Antoni
García Blas, Sergio
Morales Gallardo, María José
Elízaga, Jaime
Gómez-Blázquez, Iván
Alfonso, Fernando
García del Blanco, Bruno
Sanchis Forés, Juan
Keywords: Fragilitat
Persones grans
Infart de miocardi
Brittleness
Older people
Myocardial infarction
Issue Date: 10-Nov-2024
Publisher: Tsinghua University Press
Abstract: Abstract: Objective To assess the prognostic impact of a routine invasive strategy according to the frailty burden in patients with non-STsegment elevation myocardial infarction (NSTEMI) from the MOSCA-FRAIL clinical trial. Methods: The MOSCA-FRAIL trial randomized 167 frail patients, defined by a Clinical Frailty Scale (CFS) ≥ 4, with NSTEMI to an invasive or conservative strategy. The primary endpoint was the number of days alive and out of hospital (DAOH) one year after discharge. For this subanalysis, we compared the impact of an invasive strategy on the outcomes between vulnerable (CFS = 4, n = 43) and frail (CFS > 4, n = 124) patients. Results: Compared to vulnerable patients, frail patients presented lower values of DAOH (289.8 vs. 320.6, P = 0.146), more readmissions (1.03 vs. 0.58, P = 0.046) and higher number of days spent at the hospital during the first year (10.8 vs. 3.8, P = 0.014). The causes of readmission were mostly non-cardiac (56%). Among vulnerable patients, DAOH were similar regardless of strategy (invasive vs. conservative: 325.7 vs. 314.7, P = 0.684). Among frailest patients, the invasive group tended to have less DAOH (267.7 vs. 311.1, P = 0.117). Indeed, patients with CFS > 4, invasively managed lived 29 days less than their conservative counterparts. In contrast, there were no differences in the subgroup with CFS = 4. Conclusions: Adult patients with frailty and NSTEMI showed different prognosis according to the degree of frailty. A routine invasive strategy does not improve outcomes and might be harmful to the frailest patients.
Note: Reproducció del document publicat a: https://doi.org/10.26599/1671-5411.2024.10.005
It is part of: Journal of Geriatric Cardiology, 2024, vol. 21, num.10, p. 954-961
URI: https://hdl.handle.net/2445/219622
Related resource: https://doi.org/10.26599/1671-5411.2024.10.005
ISSN: 1671-5411
Appears in Collections:Articles publicats en revistes (Ciències Clíniques)
Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))

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